Senior Medicare Patrol

About SMP

Senior Medicare Patrol (SMP) helps Medicare and Medicaid beneficiaries avoid, detect, and report health care fraud. They both protect beneficiaries and help preserve the integrity of the Medicare and Medicaid programs by recovering and avoiding the billions of dollars typically lost to health care fraud each year.
Because face-to-face, in-person contact is most effective, SMPs nationwide recruit and teach nearly 5,000 volunteers every year to help in this effort. Most SMP volunteers are both retired and have Medicare, and are thus well-positioned to assist their peer.

SMP reaches out to Medicare beneficiaries in their communities by hosting group presentations, exhibiting at community events, answering calls to the SMP helplines, and providing one-on-one counseling. They teach Medicare beneficiaries how to protect their personal identity, identify and report errors on their health care bills, and identify deceptive or fraudulent health care practices.

Funding

SMPs are funded by the Administration for Community Living. SMP activities support ACL’s goals of promoting increased choice and greater independence among older adults and people with disabilities.

In 1995, the Administration on Aging, which is now under the ACL, became a partner in a government-led effort to fight fraud, error and abuse in the Medicare and Medicaid programs through the implementation of a ground-breaking demonstration project called Operation Restore Trust (ORT). During its demonstration phase, ORT returned $23 for every $1 spent, looking at the fastest growing areas of Medicare fraud, including home health care, skilled nursing facilities and providers of durable medical equipment. Our SMP in California is one of the original demonstration programs and continues to be a prominent piece in the fight against fraud.

Partners

California SMP collaborates with several other partner organizations to maximize our effectiveness in spreading the word on fraud and fraud prevention. Some partners include:

Volunteer Risk and Program Management (VRPM)

Volunteers are the foundation of our Senior Medicare Patrol program. With over 600 SMP volunteers throughout California alone, the Administration on Community Living created the Volunteer Risk and Program Management (VRPM) to provide policies and best practices to support all aspects of SMP volunteer recruitment, management and training. Our California Senior Medicare Patrol considers conformance with these policies and practices critical for the sustainability of a strong, dynamic and robust network of volunteers. See the Senior Medicare Patrol Resource Center for more details on this program and for resources and tools to implement these policies with your volunteers.

Testimonials

“We feel so lucky to have found the services of CHA. Without your advocacy efforts, we would have just accepted the denial from my long-term care insurance company. Because of your efforts, we received $9,386.87. Bonnie, we are so thankful there are people like you in this crazy world of health care. It shouldn't be this hard to provide care for our elderly, especially when an insurance policy has been purchased. I have shared our experience with my peers, friends and family. I highly recommend CHA and their advocacy services.”